{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T02:32:12Z","timestamp":1765247532929,"version":"3.46.0"},"reference-count":64,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Unplanned reoperation is regarded as one of the most critical indicators for evaluating healthcare quality. To date, long\u2010term data sets on unplanned reoperations following three\u2010column osteotomy (3CO) for spinal deformity patients remain largely limited. To uniquely investigate the incidence, causes, and timing of unplanned reoperations following 3CO procedures for pediatric and adult spinal deformities, with a focus on long\u2010term follow\u2010up outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed data of all consecutive pediatric and adult spinal deformities who underwent single\u2010posterior 3CO procedures between 2013 and 2016 from a single scoliosis center. The timing of revisions was categorized as perioperative (0\u20136\u2009weeks), short\u2010term (6\u2009weeks\u20132\u2009years), intermediate\u2010term (2\u20135\u2009years), and long\u2010term (&gt;\u20095\u2009years). Statistical analyses were performed using the Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      test for continuous variables and chi\u2010squared test or Fisher's exact test for categorical variables between patients with and without unplanned revision surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 216 patients who underwent 3CO procedures, with a median follow\u2010up duration of 10\u2009years (interquartile range, 9\u201311), 36 patients (15 pediatric and 21 adult cases) required unplanned revision surgeries, yielding an overall reoperation rate of 16.7%. The top three causes of revision were implant failure (10 cases, 4.6%), deformity progression (nine cases, 4.2%), and pseudarthrosis (8 cases, 3.7%). Other reasons included new neurological deficits (four cases, 1.9%), infection (two cases, 0.93%), wound dehiscence (two cases, 0.93%), and acute coronal imbalance (1 case, 0.46%). Of the 36 patients who underwent revisions, 22.2% underwent revision during the perioperative period, 13.9% in the short term, 33.3% in the intermediate term, and 30.6% in the long term. Patients undergoing multilevel 3CO exhibited significantly higher unplanned revision rates than those undergoing single\u2010level 3CO (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study found that the overall unplanned reoperation rate following 3CO for spinal deformities was 16.7%. Implant failure, deformity progression, and pseudarthrosis were the most common reasons. Multilevel 3CO was significantly associated with a higher likelihood of unplanned revision surgery.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      Chinese Clinical Trial Center (registration number: ChiCTR2500096201, available online at\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.chictr.org.cn\/\">www.chictr.org.cn\/<\/jats:ext-link>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70190","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T02:01:40Z","timestamp":1762394500000},"page":"3385-3397","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence, Causes, and Timing of Unplanned Reoperations Following Three\u2010Column Osteotomy for Pediatric and Adult Spinal Deformities: A Long\u2010Term Single Center Study"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4019-9841","authenticated-orcid":false,"given":"Youping","family":"Tao","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, the Ninth Medical Center of PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenhao","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, the Ninth Medical Center of PLA General Hospital  Beijing China"},{"name":"The Second Affiliated Hospital of Anhui Medical University  Hefei Anhui Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jigong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, the Ninth Medical Center of PLA General Hospital  Beijing China"},{"name":"The Second Affiliated Hospital of Anhui Medical University  Hefei Anhui Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiaxu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, the Ninth Medical Center of PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, the Ninth Medical Center of PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haixia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, the Ninth Medical Center of PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongyu","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, the Ninth Medical Center of PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Litao","family":"Huo","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, the Ninth Medical Center of PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shibo","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, the Ninth Medical Center of PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiming","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, the Ninth Medical Center of PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuwei","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, the Ninth Medical Center of PLA General Hospital  Beijing 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